Weekly Epidemiological Monitor ISSN 2224-4220 Volume 11; Issue no 41; 14 October 2018

West Nile fever cases reported in Tunisia from week 1 to week 40, 2018 Current major event

West Nile fever in Tunisia 16 14

As of 8 October 2018, the Ministry of 12

Health of Tunisia reported 177 sus- 10

pected cases of West Nile fever 8

(WNF). Out of these, 22 are probable 6

and 17 are laboratory confirmed cas- 4 Number of suspected cassesuspected of Number

es. One death has also been reported 2

in a 27 year male who was hospital- 0 ized for meningo-encephalitis in 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 September 2018. Epidemiological weeks (date of onset of symptoms)

Editorial note West Nile fever cases reported from Update on outbreaks in the West Nile Virus (WNV) is a member Tunisia Eastern Mediterranean Region of the flavivirus genus and belongs to Year Cases Deaths MERS in Saudi Arabia; cholera in Somalia; the Japanese encephalitis antigenic 1997 111 8 complex of the family Flaviviridae. cholera in Yemen; Dengue in Yemen. WNV infection is a non-contagious 2003 112 9 Current public health events of disease, primarily transmitted by the 2012 123* 12 international concern bite of infected mosquitoes of the [cumulative No of cases (deaths), CFR %] genus Culex. The infection is often Government has already enhanced asymptomatic (80%) but, when clini- surveillance and standardized case Avian influenza: 2006-2017 cally apparent, symptoms range from management through distribution of an influenza like symptom to more guidelines and protocols in health Egypt (A/H5N1) [359 (122), 34%] severe neurological disorders and care facilities. approximately 1% of cases may pre- Egypt (A/H9N2) [4 (0)] sent with severe symptoms. The in- Human infection is most often the Ebola virus disease (EVD): 2018 cubation period of West Nile fever is result of bites from infected mosqui- toes. Mosquitoes become infected Democratic Re- usually between 3 to 14 days. public of Congo [177 (113), 63.8%] when they feed on infected birds, (DRC) WNV is endemic in Tunisia. The virus which circulate the virus in their circulates in endemoepidemic mode in blood for a few days. To date, no Dengue fever : 2018 the country. Since 1997 till 2012 three human-to-human transmission of Yemen [1 188 (7), 0.6%] major upsurge of WNV cases were WNV through casual contact has reported in the country with sporadic been documented, and no transmis- Rift Valley fever : 2018 circulation of the virus in other years sion of WNV to health care workers (Please see table). Kenya [95 (11), 11.6%] has been reported when standard From the beginning of 2018 till first infection control precautions have Uganda [23 (8), 34.8%] week of October, a total of 177 sus- been put in place. However, Trans- Cholera: 2017-2018 pected cases of West Nile fever were mission of WNV to laboratory work- reported of which 17 cases were con- ers has been reported. Somalia [6 423 (42), 0.7%] firmed by RT-PCR. Most of the cas- In the absence of a vaccine or any Yemen [ 1 234 693 (2 551), 0.2%] es were reported during the rainy specific treatment, the only way to season of late August and the month Tanzania [4 103 (78), 1.9%] reduce infection in people is by rais- of September (Please see graph). Diphtheria: 2018 ing awareness of the risk factors and Since 2010, the ministry of health of educating people about the measures Yemen [1 904 (98), 5.1%] Tunisia is frequently conducting hu- they can take to reduce exposure to man surveillance for WNV infec- the virus. Effective prevention of Bangladesh [8 202 (44), 0.5%] tions to detect early circulation of the human WNV infections depends on MERS: 2012-2018 virus and implement early preven- integrated vector control pro- tion and control measures. grammes in areas where the virus Saudi Arabia [1 882 (729), 38.7%] occurs. Emphasis should be on Yellow Fever: 2017-2018 In order to contain the current up- source reduction with community surge of the cases in the country, the participation. Brazil [1 266 (415), 32.7%]

Published by World Health Organization, Regional Office for Eastern Mediterranean, Cairo, Egypt Tel: +20 2 22765492 Fax: +20 2 2765456 Email: [email protected] Previous issues are available at http://www.emro.who.int/surveillance-forecasting-response/weekly-epidemiological-monitor/ 41